SOME people believe that a lack of scientific progress is why we have not won the war on cancer. They point to the billions of dollars poured into research since the US government took on the disease via the 1971 . And yet here we are, stuck in the trenches, they say.
The naysayers are wrong. Victory may be elusive, but not because the science is holding it back. I have seen the war from many angles: as researcher, clinician and director at the National Cancer Institute (NCI) in Bethesda, Maryland, as physician-in-chief at the Memorial Sloan Kettering Cancer Center in New York City, as director of Yale University鈥檚 Cancer Center, as president of the American Cancer Society and, most recently, as a patient.
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No, the real impediment in the war is the for it, created well before we knew much about the disease.
As a result, outdated beliefs persist; bureaucratic battles erupt among physicians and medical groups; and the Food and Drug Administration (FDA) .
The National Cancer Act gave us the resources to amass the knowledge we now have. It also freed the research community to use its knowledge and tools efficiently, unencumbered by agency bureaucracies.
But it wasn鈥檛 perfect. The draft act had called for the NCI, rather than the FDA, to approve cancer drugs as the institute better understood the issues, both scientific and practical. That didn鈥檛 happen, and the FDA stands for patients awaiting new drugs.
Its superior understanding also won the NCI independence from the rest of the National Institutes of 91色情片, but it has allowed this independence to be eaten away. The act also established cancer centres in universities, but they got embroiled in academic politics and fundraising battles.
So I say it is time for a new act, one that combines additional resources with the flexibility to untangle strangling regulation. It should allow NCI-funded centres to operate as independent NCI replicas, where research is done in concert with treatment. It would shift authority for early clinical trials from the FDA to the cancer centres. This would get new discoveries to patients much quicker. Finally, we need a cancer czar with control over the programme鈥檚 budget.
If we do all this, we will soon see the end of cancer as a major public health issue. We have the critical mass of scientific knowledge; we need only to get around . The American people, who funded this war, deserve to see a victory.
(Image: Andrzej Krauze)
This article appeared in print under the headline 鈥淐ancer鈥檚 final act?鈥�
